Welcome to our Doctor’s Q&A corner!
Today Dr Virdi answers questions on the cardiovascular side of peri- menopause and menopause. Send in your questions for the next edition. All personal details remain confidential. We will only publish your question.
Question:
“Could symptoms like palpitations or shortness of breath be hormone-related, or should they be investigated further?”
”How does menopause affect my heart health and cardiovascular risk? At what stage of menopause does heart risk typically begin to rise?"
”Are heart attack symptoms different in women, especially during menopause? What symptoms should I never ignore, even if they seem mild or unusual?”
Answer:
“Could symptoms like palpitations or shortness of breath be hormone-related, or should they be investigated further?”
Palpitations can be a common symptom during perimenopause and menopause. In some women, they may occur as an isolated and troublesome symptom, even when there are no obvious signs pointing to a hormonal cause. It is still important to investigate palpitations appropriately, and many women will undergo checks such as an ECG, blood tests, blood pressure monitoring, or further assessment of heart function. These investigations are often reassuring and may come back normal, but they are valuable in helping to exclude underlying cardiac causes.
Shortness of breath, however, is not considered a typical symptom of menopause. If you are experiencing breathlessness, it is important to seek review by your GP so that appropriate assessment and investigation can be arranged.
”How does menopause affect my heart health and cardiovascular risk? At what stage of menopause does heart risk typically begin to rise?"
Heart disease risk increases after menopause because falling oestrogen levels reduce some natural cardiovascular protection. Risk often starts to rise during perimenopause and becomes more noticeable after menopause itself (12 months without periods).
Other important risk factors include smoking, diabetes, high blood pressure, raised cholesterol, obesity, inactivity, and a family history of early heart disease.
Maintaining a healthy lifestyle — regular exercise and strength training, not smoking, healthy weight, moderate alcohol intake, and managing blood pressure and cholesterol — becomes especially important at this stage.
For suitable women, Hormone Replacement Therapy started around menopause may also have cardiovascular benefits.
”Are heart attack symptoms different in women, especially during menopause?”
“What symptoms should I never ignore, even if they seem mild or unusual?”
Heart attack symptoms in women, including during menopause, can sometimes be less obvious than the “classic” severe chest pain. Symptoms may feel mild or be mistaken for indigestion, anxiety, or fatigue.
Never ignore:
* Chest pain, pressure, or tightness
* Pain spreading to the arm, jaw, neck, back, or shoulder
* Shortness of breath
* Sweating, clamminess, nausea, or dizziness
* Sudden unusual fatigue or feeling unwell
Classic symptoms such as left-sided chest pain radiating to the left arm, jaw, or neck — especially with breathlessness or sweating — should always be treated as an emergency.
Call 999 immediately if you suspect a heart attack.